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Sport after CABG?

Plastic, Hand and Reconstructive Surgery, Hannover Medical School, Hannover 30625, Germany

Gender and physical activity one year after myocardial revascularization for stable angina

I read with great interest the recent work by Markou and coworkers focusing on gender and physical activity one year after myocardial revascularisation [1]. I would like to thank the authors for their inspiring work and comment on some issues.

Cook and coworkers analysed in 2001, 200 patients prior to CABG surgery in those with a low risk and a high risk group based on the STS National Cardiac Surgery Database prediction of operative mortality [2]. Patients with a high percent body fat and a low veterans specific activity questionnaire score were at higher risk for at least one serious complication and a longer postoperative length of stay.

We analysed a total number of 211 patients following complete arterial revasculariation using either a radial T-graft or free graft besides the internal mammary artery for coronary revascularisation [3]. Ninety-four patients (44.5%) with coronary artery disease and after radial artery harvesting performed no sports activity at all 25.7±5 months after the procedure. Approximately 50% of the patients were physically active on a regular basis. Twenty-five patients (11.8%) performed sports every day of the week. In Germany, a large number of specialized sport groups meeting the needs of patients with coronary artery disease are available. At follow-up (25.7±5 months after radial artery harvesting), 169 patients (80.1%) did not participate in such heart sport groups. Only 27 patients (12.8%) participated in such heart sport groups once a week. Concerning any cardiac rehabilitation course performed, 25 patients (11.8%) did not participate in such a cardiac rehabilitation program at all, whereas 171 patients (81.0%) attended a cardiac rehabilitation program after the procedure.

Given the demonstrated benefits of regular physical activity one has to mention and clearly promote the current revised recommendations of the American College of Sports Medicine (ACSM) and the American Heart Association (AHA) for adults over age 65 or adults 50–64 suffering chronic diseases are as followed [4]: they include moderate intense aerobic exercise 30 min a day, five days a week or a vigorously intense aerobic exercise 20 min a day, three days a week. This should be accompanied by at least 10 strength-training exercises with 10–15 repetitions of each exercise twice to three times per week, preferably associated with balance exercises.

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1. Markou ALP, Evers M, van Swieten HA, Noyez L. Gender and physical activity one year after myocardial revascularization for stable angina. Interact CardioVasc Thorac Surg 2008; 7:96–101.[Abstract/Free Full Text]
2. Cook JW, Pierson LM, Herbert WG, Norton HJ, Fedor JM, Kiebzak GM, Ramp WK, Robicsek F. The influence of patient strength, aerobic capacity and body composition upon outcomes after coronary artery bypass grafting. Thorac Cardiovasc Surg 2001; 49:89–93.[CrossRef][Medline]
3. Knobloch K, Lichtenberg A, Tomaszek S, Hagl C, Khaladj N, Klima U, Haverich A. Long-term physical activity and neurologic function after harvesting of the radial artery as T-graft or free graft in coronary revascularisation. Ann Thorac Surg 2005; 80:918–921.[Abstract/Free Full Text]
4. Haskell WL, Lee LM, Pate RR, Powell KE, Blair SN, Franklin BA, Macera CA, Heath GW, Thompson PD, Bauman A. Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc 2007; 39:1423–1434.

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